As the Irish writer George Bernard Shaw wrote in past “All professions are conspiracies against the laity”, so his argument is one that I’m familiar with.
The book is a most interesting read and pretty well balanced too which begins with a similar point, outlining the Grand Bargain between the professions and the public. The opening chapters allow them to make a fair case that this relationship has served a key purpose until now but the times are a changing….

They essentially make the case that the supply/cost of professional services (i.e. services by the professions) cannot meet the growing demands/resource of the average citizen and so with the arrival of the information technology revolution that we are living through, that this unequal relationship has to/will fundamentally change in the years and decades ahead.

The authors then take a broad look at areas such as healthcare, law, education, journalism, management consultancy, accounting and wisely and carefully look for patterns amidst that complexity. To their credit though their original research was based in the legal profession they understood their were more generic patterns at play, which is why this smart book deserves some attention.

After making the case for the change in the first part of the book, in the second they turn to a decent look at the theory that underpins their case. This theory is simply aimed at understanding two key fields, that of information and knowledge management. The point is well made that though most professionals don’t necessarily see it that way, that the professions are, by and large, information intensive industries. On this point, as a medical doctor by profession and an emergency physician by clinical background, I might be expected to challenge that key declaration, yet to be fair (as my work and related writings elsewhere on this blog makes clear) I very much agree with them.

In deconstructing the key patterns that underpin professional work to the core/generic processes that underpin them, which inevitably align to core/generic information and knowledge management processes, the essence of this book makes a very important point. Essentially all the professions, as we now know them, will inevitably be very significantly impacted by technologies that will indeed “transform the work of human experts”.

It may be useful to offer one key compliment and one key critique here..

To their credit they make a profoundly important point when they say “we argue that professional work should be decomposed, that is, broken down into its constituent ‘tasks’—identifiable, distinct, and separable modules of work that make it up. Once decomposed, the challenge then is to identify the most efficient way of executing each type of task, consistent with the quality of work needed, the level of human interaction required, and the ease with which the decomposed tasks can be managed alongside one another and pulled together into one coherent offering”.

In terms of critique what I think this book doesn’t quite expose as much as it could or should is the art of professional service. The focus is rather on the scientific decomposition of the element parts, which is of course a very useful exercise. Yet patients know that is is the art of medical practice (communication skills, surgical suturing skills etc ) that matters as much as the science (logic and reasoning). To the authors credit they address many of these points as well as they can, exploring the value of personal interaction and empathy in a fair way in later sections.

One other point worth noting is that they say “Very often, after we give talks on our ideas, we are approached by individuals who argue that what we say applies right across the professions except in one field—their own.”Again, as an emergency physician I might be expected to play that card. I choose not to. I found that I largely agree with the authors on the thrust of this book, if not all the detail..

The implications of this upheaval are explored in the third section of this book, which wisely exposes and addresses some of the inevitable skepticism that their claims are bound to be met with. For the most part they address many of these head on and deal with them fairly. As the book closes there is a slightly ominous sense of foreboding as to what the future will look like, in line with the directly related and equally powerful message delivered elsewhere online as “Humans Need Not Apply” .

To avoid a doomsday ending, they helpful conclude with a call to action rather than inaction, in tackling the future proactively, man with machine…

This is a brave, bold book which may make for uncomfortable reading for many professionals. No more than myself, my instinct is that we professionals need to understand the past and present to create the future. It goes without saying that change is inevitable…its the only constant in life..

Objections to/denial of the key messages in this book are to be expected. Yet methinks this book will stand the test of time and could be referenced in the 21st Century history books for a long time to come.

frectal

frectal is a place for to share some thoughts and ideas in a complex world.
Interests include healthcare, change, leadership, quality improvement, information systems, standards and the value of simple rules in a complex world
I hope some of these thoughts are helpful to others.